The Evolving Landscape of Stage III Endometrial Cancer—A Narrative Review of Management in Australia

In Stage III endometrial cancer (EC), treatment paradigms have evolved from being based on a purely surgical pathology classification to a nuanced system integrating molecular risk stratification and advances in immunotherapy and targeted agents. This narrative review summarises current adjuvant management of stage III EC with an emphasis on clinical management in Australia, given the challenges in decision-making with the development of new predictive and prognostic markers and systemic agents. We discuss the importance of surgical staging, the evidence for radiotherapy and chemotherapy, explore emerging targeted and immunotherapy options, and outline barriers such as cost, access to molecular testing and systemic therapy in the Australian context. Molecular profiling is transforming adjuvant therapy in EC, but gaps in knowledge persist. Further research will help clarify the role of targeted treatments and immunotherapy in the adjuvant setting in this group of patients.